Allogeneic cellular immunotherapy for opportunistic infection

ABSTRACT

A method for stimulating the immune system in immunocompromised patients in order to treat opportunistic infection. The method involves the infusion of intentionally mismatched allogeneic cells. In order to prevent graft vs. host disease complications, the allogeneic cells can be irradiated prior to infusion.

CROSS-REFERENCE TO RELATED APPLICATION

The present application is a continuation of and claims priority of U.S.patent application Ser. No. 11/251,585, filed Oct. 14, 2005, which isbased on and claims the benefit of U.S. provisional patent applicationSer. No. 60/618,682, filed Oct. 14, 2004, the contents of which arehereby incorporated by reference in their entirety.

FIELD OF THE INVENTION

This invention relates to the use of allogeneic cell infusions to treatdisease. More particularly, the invention relates to an allogeneic celltherapy for the stimulation of cellular immunity in immunocompromisedhosts.

BACKGROUND

The human immune system is capable of protecting individuals frominfection by a variety of bacterial, protozoal, fungal, and viralpathogens. However, when the immune system is weakened by age or disease(e.g., HIV infection) or by medication (corticosteroids, chemotherapy)or by treatments to prevent rejection in organ or bone marrowtransplantation patients, these pathogens that normally do not causeclinic disease can cause infections. The common opportunistic pathogensare fungi, mycobacterium avium cellulare, viruses, particularlycytomegalovirus infection (CMV), and pneumocystis carinii. Patients withHIV infection, organ and bone marrow transplants are particularlyvulnerable to opportunistic infections.

The immunosuppressed individual is vulnerable to both endogenous andexternal organisms. Opportunistic infections can result from exogenousacquisition of a particularly virulent pathogen (eg, meningococcalmeningitis or pneumococcal pneumonia), reactivation of an endogenouslatent organism (eg, herpes simplex virus (HSV), herpes zoster virus(HZV or shingles), or tuberculosis, and endogenous invasion of anormally commensal or saprophytic organisms (eg, bacteria, viruses,fungi, or protozoa/parasites). The exact type of opportunistic infectionthat occurs depends on the type and extent of immunologic alteration,whether it be cellular, humoral, phagocytic, or a combined defect; andon organisms present in the internal and external environments.Opportunistic infections are often lethal despite treatment withanti-viral, anti-fungal or antibiotic medications. Therefore, there is aneed to develop methods to strengthen the immune system ofimmunocompromised individuals to both treat and prevent opportunisticinfection.

SUMMARY OF THE INVENTION

The present invention comprises a method for stimulating the immunesystem in immunocompromised patients in order to treat opportunisticinfection. The method involves the infusion of intentionally mismatchedallogeneic cells. In order to prevent graft vs. host diseasecomplications, the allogeneic cells can be irradiated prior to infusion.

DETAILED DESCRIPTION OF ILLUSTRATIVE EMBODIMENTS

Aspergillus is a prototypical opportunistic organism. Aspergillus is afilamentous, cosmopolitan and ubiquitous fungus found in nature. It iscommonly isolated from soil, plant debris, and the indoor airenvironment. Aspergillosis is a large spectrum of diseases caused bymembers of the genus Aspergillus. Among all filamentous fungi,Aspergillus is in general the one most commonly isolated in invasiveinfections. It is the second most commonly recovered fungus inopportunistic mycoses following Candida (Kwon-Chung 1992). Aspergillusfumigatus is also the most common cause of invasive aspergillosis (IA).

IA is a fulminant and highly lethal infection that is common inimmunocompromised patients (Bodey and Vartivarian 1989; Denning 1998).Immunosuppression is the major factor predisposing to development ofopportunistic infections (Ho and Yuen 2000). Colonization of therespiratory tract is very common. The infection is initiated uponinhalation of conidia (fungal spores) by immunocompromised patients.Conidia are efficiently cleared from the lungs in healthy individuals,but in immunocompromised patients they can germinate to form hyphae thatinvade the surrounding tissues, resulting in a severe and progressivepneumonia that can subsequently disseminate to other organs. Theclinical manifestation and severity of the disease depends upon theimmunologic state of the patient (Bennett 1995). Lowered host resistancedue to such factors as underlying debilitating disease, neutropeniachemotherapy, disruption of normal flora, or an inflammatory responsedue to the use of antimicrobial agents and steroids can predisposepatients to colonization, invasive disease, or both (Morrison, Haake etal. 1993).

Therapy for IA is associated with poor outcomes with an overallmortality rate of approximately 60% (Stevens, Kan et al. 2000). IA is anespecially serious problem following bone marrow transplantation (BMT)due to steroid-induced immunosuppression and chemotherapy-inducedneutropenia (Peterson, McGlave et al. 1983; Meyers 1990).

The antifungal agents approved for the treatment of IA have clinicalresponse rates ranging from 33% to 52% (Patterson 2002). Currenttherapies for IA include: voriconazole (Herbrecht, Denning et al. 2002);amphotericin B, which causes nephrotoxicity in 80% of patients (Wingard,Kubilis et al. 1999); liposomal amphotericin B which is a lessnephrotoxic formulation (Walsh, Finberg et al. 1999), but can behepatotoxic and is highly expensive; itraconazole which has many druginteractions (Caillot 2003); surgical excision of infarcted tissue(Matt, Bernet et al. 2003); and caspofungin, recently approved by the USFood and Drug Administration as salvage therapy for IA patientsrefractory or intolerant to other therapies. However, despite aggressiveanti-fungal therapy, the prognosis for IA in BMT patients remainsextremely poor with mortality rates of 90% or more (Denning and Stevens1990; Denning 1996).

Because treatment outcomes remain suboptimal for IA, new approaches fortherapy are required. Methods that can stimulate cellular (Th1) immunityare thought to be the most effective in treating opportunistic viral andfungal infection.

Th1/Th2 Immunity

Adaptive immunity is characterized as Th1 or Th2 depending on thepredominant type of CD4+ T-cell involved in the response. The balance ofcytokines produced by Th1 cells and Th2 cells is a key factorinfluencing the character of an immune response. The functional divisionof CD4+ lymphocytes into Th1 and Th2 subsets is based upon theircytokine profile. Th1 cells produce gamma interferon (IFN-γ) andinterleukin-2 (IL-2), but not IL-4. Th2 cells produce IL-4 and IL-10,but not IFN-γ (Mosmann and Coffman 1989; Romagnani 1991). Cytokinesproduced by these two subsets are mutually inhibitory and establish areciprocal cross regulation. Th1 cells inhibit the proliferation of Th2cells and Th2 cells inhibit Th1 cell cytokine production (Fiorentino,Bond et al. 1989). This cross regulation results in a polarized Th1 orTh2 immune response to pathogens that can determine either hostresistance or susceptibility to infection. Th1 cells differentiate inthe presence of IL-12 (and potentiated by IL-18) secreted by dendriticcells (DC), while Th2 cells differentiate under the influence of IL-4produced by NKT cells, basophils, eosinophils, and mast cells. A Th1response in protozoan, viral or fungal infection is associated withresistance, while a Th2 response to these pathogens is associated withdisease (Kawakami 2003).

Natural Infection Control

Activation of both innate and adaptive immune mechanisms are essentialfor host control of fungal infection. Effector mechanisms of the innateimmune system are a major defense against IA (Roilides, Katsifa et al.1998). Resistance to infection requires unimpaired innate anti-fungalactivity of pulmonary phagocytic cells operating in a cytokineenvironment rich in TNF-α and IL-12, as well as the presence ofinterstitial T-cells producing IL-2 and IFN-γ (Cenci, Mencacci et al.1998). Resident alveolar macrophages ingest and kill resting condia,while neutrophils attack hyphae germinating from condia that escapemacrophage surveillance (Schaffner, Douglas et al. 1982). Theeffectiveness of this immune response is evident from the observationthat challenge, even with a large number of condia, fails to causedisease in immunocompetent animals (Dixon, Polak et al. 1989).

Dendritic cells (DC) are the innate immune cells recognized asinitiators of the immune response to pathogens, including Aspergillus,and serve as a bridge between innate and adaptive immunity. DC have aprimary role in surveillance for pathogens at the mucosal surfaces(Banchereau and Steinman 1998). A dense network of DC has been describedin the respiratory tracts (Pollard and Lipscomb 1990). In the restingstate, respiratory tract DC are specialized for uptake and processing,but not for presentation of antigen (Ag), the latter requiring cytokinematuration signals (Stumbles, Thomas et al. 1998).

Immature DC in the respiratory track recognize and phagocytose fungus.Upon phagocytosis and signaling from inflammatory cytokines, such asTNF-DC become activated and then migrate as mature DC to the lymph nodes(Bozza, Gaziano et al. 2002; Bauman, Huffnagle et al. 2003). Mature DCin turn activate naive T-cells in the lymph nodes via presentation offungal antigen in the context of MHC I and MHC II molecules, concurrentwith the expression of co-stimulatory molecules. Cytokine production byDC determines the development of either a Th1 or Th2 adaptive immuneresponse (Huffnagle and Deepe 2003).

In murine models of aspergillosis, Th1 cytokines correlate withprotection from disease while Th2 cytokines correlate withsusceptibility (Nagai, Guo et al. 1995; Cenci, Perito et al. 1997).Development of protective adaptive immunity is associated withactivation of Th1 cells producing IFN-γ and macrophages producing IL-12.Consistent with this observation, neutralization of the Th2 cytokine,IL-4, or administration of the Th1 cytokine, IFN-γ has a curative effecton Aspergillus infection, whereas IFN-γ neutralization and increasedproduction of the Th2 cytokine, IL-10, results in increased pathology(Nagai, Guo et al. 1995). Th1 immune responses have also been shown tosuccessfully control IA in patients with hematological malignancies(Hebart, Bollinger et al. 2002)

Post Engraftment Immunity

Patients with an impaired cellular immune response are predisposed tocancer and infection. Impaired cellular immunity can be triggered by thepresence of malignant or viral diseases, or iatrogenically throughimmunosuppressive drugs, transplantation, chemotherapy, or irradiation.Impaired cellular immunity and disease is correlated with imbalances inTh1/Th2 cytokines in favor of Th2 immunity and effector function(Shurin, Lu et al. 1999; Kidd 2003). Enhanced Th2 responses, creating animmunosuppressed state, are present in infectious diseases such aschronic hepatitis C virus infection (Fan, Liu et al. 1998), leprosy(Yamamura 1992), helminth, protozoa and retrovirus infection(Gazzinelli, Makino et al. 1992; Sher, Gazzinelli et al. 1992), AIDS(Clerici and Shearer 1993) and as part of the aging process (Deng, Jinget al. 2004).

In the allogeneic BMT setting, allogeneic cell infusions elicit ananti-tumor effect called the graft vs. tumor (GVT) effect mediatedthrough the enhancement of Th1 immunity (Jung; Foley et al. 2003). Theenhanced Th1 immunity after allogeneic BMT is also correlated witheffective immune surveillance for prevention or delay in cancer relapse(Guo, Qiao et al. 2004). However, the beneficial effects of GVT areoften offset by the occurrence of graft-vs-host disease (GVHD), whichremains the major complication of allogeneic BMT.

GVHD is initiated by alloreactive donor T-cells recognizing foreign HLA(Human Leukocyte Antigen) antigens of the host. Dysregulation ofcytokine networks is the primary cause of GVHD (Krenger and Ferrara1996). Th1 cytokine release dominates in GVHD (Rus, Svetic et al. 1995;Ochs, Blazar et al. 1996; Das, Imoto et al. 2001), while Th2 cellsinhibit GVHD lethality (Fowler, Kurasawa et al. 1994). Therapy forchronic GVHD is highly immunosuppressive and must be continued for aprolonged time. The most widely employed first line therapy fortreatment of chronic GVHD is a cyclosporine A (CSA) and prednisoneregimen. Both CSA (Kim, Cho et al. 2000) and prednisone (Elenkov 2004)treatment tends to inhibit Th1 immunity and promote Th2 immunity.

GVHD control requires suppression of cellular immune mechanisms andenhancement of Th2 immunity Immunosuppression to control GVHD makespatients susceptible to opportunistic infection from a broad array ofpathogens. These infections, including aspergillus infection, are themajor cause of death secondary to GVHD, followed by progressive organfailure from the chronic GVHD immune response. Immunosuppressed patientshave high levels of IL-10 in plasma. IL-10 is produced by Th2lymphocytes, macrophages, mast cells and B-cells (Moore, O'Garra et al.1993) and has potent immunosuppressive properties, capable of enhancingTh2 immune responses and inhibiting differentiation of a Th1 response(de Vries 1995). Treatment of GVHD with glucocorticoids directlyenhances the induction of IL-10-producing T cells. IL-10 is known toinhibit the production of IL-12 and the expression of MHC class II Agsand costimulatory molecules by macrophages, monocytes, and various typesof dendritic cells (Moore, de Waal Malefyt et al. 2001). Furthermore,IL-10 treatment of dendritic cells contributes to a state of anergy inalloantigen-activated T cells (Groux, Bigler et al. 1996; Steinbrink,Wolfl et al. 1997). Aspergillus is also capable of directly stimulatingthe production of IL-10 (Clemons, Grunig et al. 2000). ParticulateAspergillus antigens have been shown to elicit Th2 responses in Balb/cmice (Kurup, Seymour et al. 1994).

Therefore, the challenge of designing an immunotherapy to treat IA andother opportunistic infections in the post-engraftment BMT setting is todesign a method to enhance anti-pathogen Th1 immunity in animmunosuppressed, Th2-biased setting without exacerbating GVHD.

Allogeneic Cell Therapy

In order to develop an effective immunotherapy for IA and otheropportunistic infections in the post-engraftment BMT setting, it isnecessary to first stimulate innate immunity and then induce afungus-specific (or other pathogen-specific) Th1 adaptive immuneresponse against a background of immunosuppressive drugs, as well asexisting and imprinted Th2 skewed immunity to the offending pathogen. Anadditional challenge is the need to elicit Th1 anti-fungal (or otherpathogen-specific) immunity in this background without concurrentstimulation of Th1-mediated GVHD.

In general, generation of an effective Th1 adaptive immune responserequires a defined cascade of immunological events that must occur underrigorously controlled conditions. The infusion of HLA-mismatchedallogeneic cells into an immunocompromised host elicits a strong hostallorecognition response capable of triggering this cascade of events.These events include: (i) the activation of innate effector mechanismscausing the shedding of fungal (or other) antigen (Ag); (ii) the uptakeand processing of fungal (or other) Ag by dendritic cells in the lungs;(iii) the migration of the dendritic cells to the draining lymph nodesand the subsequent presentation of fungal (or other) Ag in the contextof MHC I or MHC II molecules to naïve T-cells; (iv) the conditioning ofthe lymph node microenvironment for differentiation of Th1 effectorcells; (v) the migration and extravasation of primed fungal-specific (orother) Th1 effector cells to the site of infection; and (vi) effectorcell recognition and clearing of fungus (or other pathogen) from thetissue. All these events must occur in the context of a sustainedpro-inflammatory Th1 cytokine environment. Failure of any of theseevents to occur in the correct cytokine context will result in aninadequate anti-fungal (or other) immune response.

Therefore, in order to create an environment conducive to development ofde-novo Th1 antifungal (or other) immunity, it is first necessary toinduce the expression of Th1 cytokines and maintain this cytokineenvironment during the activation of innate immune effector cells anduntil the establishment of an anti-fungal (or other) Th1 adaptive immuneresponse. The presence of Th1 cytokines will down regulate the existingTh2 cytokines. In order to initially change the existing Th2-dominatedimmune environment in the fungal-infected immunocompromised host, infuseHLA-mismatched allogeneic lymphocytes, preferably activated Th1lymphocytes expressing high density CD40L. Infusion of HLA-mismatchedallogeneic cells elicits a burst of Th1 cytokines from host immune cellsas part of the rejection response. It is known that a predominance ofTh1 cytokines are produced after allogeneic cell infusion (Carayol,Bourhis et al. 1997). Further, it has been observed that in mixedlymphocyte reactions, allogeneic stimulator cells elicit production ofTh1 cytokines from responder cells (DuPont and Hansen 1976; Toungouz,Denys et al. 1995). In addition, T cell stimulation by multiple HLAmismatches in rhesus macaques facilitates polarization toward aproinflammatory Th1-like response in vitro and in vivo in transplantrecipients (Lobashevsky, Wang et al. 1998). There is also a predominanceof Th1 type cytokines in the development of human GVHD induced byallogeneic cell infusion (Das, Imoto et al. 2001).

Clinically, reduced numbers or impaired function of neutrophils are byfar the best-characterized risk factors for invasive aspergillosis(Wald, Leisenring et al. 1997). Th1 cytokine production as a result ofthe allogeneic cell infusion will serve to activate alternativeanti-fungal innate effector cells. The Th1 cytokines (predominantlyIFN-γ, TNF-α, IL-1, IL-2, IL-12 and IL-18) produced as a result of theallogeneic cell infusion and the rejection response activate alternativeinnate immune effector cells such as NK cells and DC, as well activateT-cells (Antin and Ferrara 1992). In turn, these cells produce Th1cytokines which create an autocrine and paracrine cytokine networkserving to both maintain and enhance the production of Th1 cytokines(Mailliard, Son et al. 2003). Activated innate immune cells produceIL-12 and IL-18, which synergistically act in autocrine feedback loop toenhance the production of IFN-γ (Micallef, Tanimoto et al. 1997;Okamura, Kashiwamura et al. 1998). The production of IFN-γ by activatedNK cells functions in the priming process of Th1 cells, which in turnsupports the expansion and effector function of CD8+ CTLs in the Th1adaptive immune response (Trinchieri 1995).

The activation of NK cells and DC by the Th1 cytokines produced inresponse to the allogeneic infusion are essential elements forgenerating de-novo fungal Ag shedding and presentation to T-cells in aTh1-steering environment. NK cells are essential for protection againstviruses, parasites, bacteria as well as fungi (Trinchieri 1989). Inimmunocompromised hosts, recruitment of NK cells to the lungs has beenshown to be an effective defense mechanism against IA (Morrison, Park etal. 2003). DCs orchestrate the overall antifungal immune resistance inthe lungs and were also found to be essential in the activation of Th1responses to aspergillus, in vivo (Bozza, Gaziano et al. 2002) and invitro (Grazziutti, Przepiorka et al. 2001).

DCs become activated in the presence of Th1 cytokines. Activated DCshould subsequently traffic to draining lymph nodes after uptake offungal Ag. These DC will have enhanced ability for presentation ofantigenic products of these pathogens to T-cells via the MHC I and MHCII pathways. Activated DC are capable of producing IL-12 followingexposure to fungal Ag and IL-12 production by DC has been shown toinduce Th1 immunity (Heufler, Koch et al. 1996). It is furtherhypothesized that the host T-cells activated by Th1 cytokines resultingfrom the allogeneic rejection response will express the CD40L surfacemarker. CD40L is expressed on the surface of activated T-cells. CD40ligation of DC by CD40L-expressing T-cells triggers enhanced DC IL-12production and enhances upregulation of co-stimulatory molecules and thecapacity to present Ag (Cella, Scheidegger et al. 1996; Kelsall, Stuberet al. 1996). CD40-CD40L interaction is crucial for the IL-12-dependentpriming of Th1 cells in vivo (Kelsall, Stuber et al. 1996).

The foreign MHC antigens expressed by the infused allogeneic cells areeither taken up by host APC in a conventional self-MHC restricted manner(indirect alloreactivity) and/or are recognized directly on the surfaceof the infused cells by the T-cell receptor (TCR) of the host T-cells(direct alloreactivity). The host allogeneic response by eithermechanism will result in the rejection of the infused cells and theestablishment of Th1 adaptive immunity specific to the alloantigens(Ciubotariu, Tsang et al. 2002). It is hypothesized that in the presenceof adjuvant Th1 cytokines, a pool of Th1 memory cells specific for thealloantigens will develop in the host. Subsequent allogeneic cellinfusions should activate these resulting allo-specific memory cells.Activated memory cells express chemokine receptors CCR5, CCR2 or CCR3that stimulate the upregulation of adhesion receptors in the lungendothelium and permit extravasation to sites of local fungal infection(Sallusto, Lanzavecchia et al. 1998). The non-specific infiltration andcytokine production of activated Th1 memory cells at the site of fungalinfection has a potent stimulatory effect on local innate and adaptiveimmune cells responding to the fungus.

When the immune system is biased by a high frequency of memory cellsspecific for a given pathogenic antigen, the activation of these cellsduring an unrelated pathogen infection can significantly enhanceclearance of the unrelated infection (Selin, Varga et al. 1998). Thepathogenesis of viral infections in the lung has been shown to berelated to the host experience with unrelated pathogens (Chen, Fraire etal. 2003). This immunological mechanism is known as “heterologousimmunity” (Selin, Varga et al. 1998; Chen, Fraire et al. 2003).Therefore, multiple allogeneic cell infusions can create a memory poolthat will enhance anti-fungal (or other opportunistic organism) immunityby the same or similar mechanism.

Background support for this described mechanism of immunity toopportunistic organisms by enhanced Th1 immunity to an alloantigencausing a switch in existing Th2 immunity to a resident infection to Th1immunity is supported by several observations. For example, the oppositeshift occurs in infection with Schistosoma mansoni which induces a Th2immune response. This response causes a down-regulation of existing Th1responses and elevation of Th2 responses to unrelated foreign immunogens(Kullberg, Pearce et al. 1992). Th1-mediated pathology in mouse modelsof disease can be ameliorated by concurrent infection with an unrelatedparasite which elicits Th2 immunity (Whary and Fox 2004). Adoptiveimmunotherapy can induce anti-tumor activity through the production ofTh1 cytokines, even though the transferred cells are not able torecognize tumor antigens. For example, polyclonal Th1 cells administeredto mice with non-immunogenic tumors resulted in rejection of 60-90% ofthe tumors. Cured animals developed a tumor-specific memory and werecapable of rejecting rechallenges with the same tumor (Saxton, Longo etal. 1997). Similarly, co-injection of a PPD-specific Th1 clone and PPDantigen in a murine metastatic tumor model produced anti-metastaticeffects and anti-tumor activity (Shinomiya, Harada et al. 1995).

That Th1 immunity to fungus can be induced in an immunosuppressed hostis supported by the observation that immunization of cortisoneimmunosuppressed mice with multiple injections of A. fumigatus confersprotection to rechallenge with a lethal dose of condia in the context ofincreased production of Th1 cytokines (Centeno-Lima, Silveira et al.2002). In addition, Th1 immunity can be preserved (Williams, Adams etal. 2003) and also be induced in chimeric hosts (Ildstad, Wren et al.1985; Ruedi, Sykes et al. 1989).

In conclusion, multiple infusions of HLA-mismatched allogeneic cells,preferably activated Th1 cells expressing high density CD40L, intoimmunocompromised hosts with opportunistic infection causes a burst ofTh1 cytokines that will serve as the background in which activated cellsof both the innate and adaptive immune system will generate a de-novoTh1 immune response against the pathogen.

The allogeneic cell infusions are preferably activated Th1 cells from aHLA-mismatched donor. The allogeneic cells should be irradiated prior toinfusion into immunocompromised patients to prevent engraftment andGVHD.

A preferred protocol is to first prime the patient with an intravenousinfusion of allogeneic cells of dosages between 1×10⁶ to 1×10¹⁰ cells.After at least 7 days, inject additional allogeneic cells mixed with asource of antigens from the pathogen (preferably freeze/thawedorganisms) and inject the mixture intradermally. If necessary,additional intradermal or intravenous injections of either thealloantigen source alone or mixed with the pathogen antigen source canbe administered as booster injections.

EXAMPLES The Animal Model

A. fumigatus was subcultured in potato-dextrose agar slants for 5 daysat 27° C. Conidia were harvested from cultures with 0.1%phosphate-buffered saline (PBS) Tween 20. Conidia suspension wascentrifuged for 2 min at 13 000×g, supernatant rejected, and cellscounted. The concentration was adjusted to administer 10⁷ or 10⁸ conidiaper mouse in a volume of 20 μl of sterile PBS Tween 20. Mice wereimmunosuppressed by intraperitoneal administration of four doses of 250mg/kg of cortisone acetate as follows: (a) 3 days before infection, (b)on infection day, and (c) at day 2 and day 4 after infection.Cortisone-treated mice infected with a high inoculum of A. fumigatusconidia developed a lethal infection, while immunocompetent miceinfected with the same inoculum were able to control the fungus.

Allogeneic Th1 Cells

Th1 cells were prepared from Balb/c mice. Spleen cells from the micewere harvested and ACK lysed. T1 cells were generated using anti-CD3 andanti-CD28 (CD3/CD28)—coated magnetic beads at a bead/T cell ratio of 3:1with 20 IU/mL recombinant human IL-2, 20 ng/mL rhIL-7, 10 ng/mLrecombinant murine IL-12, 10 μg/mL antimurine IL-4 mAb and 3.3 mMN-acetyl-cysteine in RPMI 1640 complete media containing 10% FBS,penicillin-streptomycin-glutamine, nonessential amino acids (NEAA), and2-mercaptoethanol (2-ME; Life Technologies). Cytokine-containingcomplete media was added daily from days 2 to 6 to maintain cellconcentration between 0.2 and 1.0×10⁶ cells/mL. However, rmIL-12 wasonly added on day 0 of culture. After 5 days, in culture, the cells weremixed with anti-CD3/anti-CD28 coated biomagnetic particles (Miltenyi)and harvested for use on day 6.

Example #1

Immunosuppressed C57BL/6 mice were inoculated with a lethal dose (10⁷conidia) of fungus. The mice were divided into an untreated controlgroup, a single allogeneic infusion group and a vaccinated group (n=8 ineach group).

The single allogeneic infusion group received an iv infusion of 1×10⁶activated allogeneic CD4+ Th1 cells (irradiated) on day 7 post inoculum.

The vaccinated group received a priming dose of 1×10⁶ activatedallogeneic CD4+ Th1 cells (irradiated) on day 7 post inoculum. On day14, the mice were injected intradermally in the hind leg with 1×10⁴activated allogeneic CD4+ Th1 cells mixed with supernatant from 10⁶conidia that had previously undergone 2 cycles of freezing and thawing.

The infection of immunosuppressed mice resulted in 100% mortality after5-7 days, while all the immunocompetent infected mice survived.Necropsies of death mice organs revealed fungal invasion and destructionof the organs observed (brain, lungs and kidneys).

The mice with a single infusion survived a mean of 22 dayspost-infection (12-28 day range).

The 5 of 8 vaccinated mice survived greater than 30 days with noevidence of infection. These data demonstrate that allogeneic cellinfusion can lead to fungus control and mice survival.

Although the present invention has been described with reference topreferred embodiments, workers skilled in the art will recognize thatchanges may be made in form and detail without departing from the spiritand scope of the invention.

What is claimed is:
 1. A method of generating a de-novo Th1anti-pathogen immunity in a host comprising: inducing expression of Th1cytokines; maintaining the Th1 cytokine environment during theactivation of innate immune effector cells and until establishment of ananti-pathogen Th1 adaptive immune response wherein the host has aTh2-biased immunity.
 2. The method of claim 1 wherein the innate immuneeffector cells comprise NK cells and DC.
 3. The method of claim 1wherein the inducing comprises administration of allogeneic cells to thepatient.
 4. The method of claim 3 wherein the allogeneic cells areactivated T-cells.
 5. The method of claim 3 wherein the allogeneic cellsare HLA-mismatched to the host.
 6. The method of claim 3 wherein theallogeneic cells are irradiated prior to administration to the host. 7.The method of claim 3 wherein the allogeneic cells are administeredintravenously.
 8. The method of claim 1 wherein the maintainingcomprises administration of additional allogeneic cells.
 9. The methodof claim 8 wherein the additional allogeneic cells are administeredintradermally or intravenously.
 10. The method of claim 1 wherein themaintaining comprises administration of allogeneic cells and pathogenantigens.
 11. The method of claim 1 wherein the pathogen is a member ofthe genus Aspergillus.
 12. The method of claim 1 wherein the inducingand maintaining are performed without exacerbating GVHD in the host.